Prediabetes is a significant warning that most people ignore. About 136 million Indians are estimated to have prediabetes, more than the number of people with diabetes. It rarely shows symptoms, but it can damage blood vessels, kidneys, and nerves. Studies show that 70 to 80 percent of prediabetic people are likely to develop full-blown diabetes if they do not take action within ten years. However, the situation is not hopeless because prediabetes is reversible, and the first two to three years after diagnosis are the most critical.
1. Act Within the Two-Year Window
When it comes to reversing prediabetes, timing really matters – a study conducted recently in India and published in the Journal of Diabetes and Metabolic Disorders found that almost 60 percent of people reversed their prediabetic state within the first two to three years after diagnosis. After this ‘reversal window’ has passed, chances of returning to normal blood sugar decrease steadily and for good reasons. Pancreatic beta cell function decreases by roughly 5 percent per year after diagnosis of insulin resistance, so that by the time fasting glucose reaches diabetic thresholds, beta cell capacity is already compromised by 50 percent or more in most patients. Early intervention is therefore vital for preserving the remaining endocrine potential.
2. Lose Five to Ten Percent of Your Body Weight
For reversing the process of prediabetes, weight loss is the most potent single intervention. The most effective weight loss for reversing prediabetes is a loss of only 5 to 7 percent of the body weight or about 4 to 5.6 kilograms if it is an 80-kilogram person. This substantially improves insulin sensitivity and lowers fasting glucose levels. The Diabetes Prevention Program showed that modest weight loss combined with physical activity reduced the risk of losing diabetes by 58 percent. In this study, there was no requirement for participants to go on very strict diets. It is more effective to make small reductions in calorie intake that last indefinitely than to go on a very strict diet that is subsequently abandoned. Similar results have been found in the Indian Diabetes Prevention Programme, which was conducted in South Asian populations.
3. Reduce Total Carbohydrates, Not Just Refined Grains
Prediabetes: Replacing Refined Carbohydrates with Whole Grains is Not Enough
Much of the advice on the dietary management of prediabetes focuses on replacing refined grains with whole grains. However, the ICMR-INDIAB Survey-21 revealed that such a measure by itself is not sufficient. For the typical Indian diet in which approximately 62 percent of calories come from carbohydrates, merely substituting refined grains with whole wheat or millet failed to confer significant protection against diabetes. Rather, decreasing overall carbohydrate consumption and increasing protein intake was found to be more beneficial. The study found that replacing only 5 percent of dietary energy from carbohydrates with protein from plant sources, dairy products, eggs, or fish reduced the risk of developing type 2 diabetes and prediabetes. A higher level of protection was seen with protein from dairy sources, which decreased the risk by 11 percent.
4. Aim for 150 Minutes of Weekly Physical Activity
Exercise improves insulin sensitivity regardless of weight loss, and even a small amount of physical activity is better than none. The minimum requirement should be 150 minutes of moderate exercise per week, which is the same as a brisk 30-minute walk 5 days a week. Walking is an excellent type of physical activity because it is accessible to almost everyone. Taking a walk for 10 or 15 minutes after a meal could reduce post-meal glucose levels. Finally, strength training helps increase muscle mass, and muscles absorb glucose, so this type of exercise, combined with endurance activities, should be included in the daily routine.
- Walk briskly for 30 minutes five days per week.
- Take 10- to 15-minute walks after meals.
- Do two to three sets of bodyweight exercises or use light weights, two to three times a week.
5. Prioritize Protein in Every Meal
Protein reduces the absorption of carbohydrates, increases satiety and preserves muscle mass during weight loss. In Indian diets, protein makes up for just about 12 percent of the energy, which is significantly less than the 15 percent recommended. Boosting it to 20-30 percent of the daily calories could improve glucose tolerance. Incorporate dal, pulses, paneer, Greek yoghurt, eggs, fish and chicken into the diet. Consuming protein and vegetables before the carbs at the start of a meal could also lower the post-meal spike in glucose.
6. Improve Sleep and Manage Stress
Both sleep deprivation and chronic stress contribute to the development of insulin resistance through increased cortisol levels and disruption of circadian rhythm. Poor quality of sleep at night can elevate blood sugar levels and increase the cravings for starchy foods. A person should aim for seven to eight hours of healthy sleep per night and try to maintain a set sleeping schedule. Avoiding electronics an hour or so before bedtime and keeping the sleeping environment cool and dark is a good way to improve sleep quality. Moreover, practicing relaxation techniques can reduce stress levels and cortisol in the body, which positively affects one’s metabolism. The D-CLIP study conducted in India proved that lifestyle changes could lower the risk of diabetes by 32% among patients over a period of three years.
7. Monitor Progress and Seek Medical Support
Consistent monitoring creates accountability and makes it possible to adjust promptly. Prediabetic patients are recommended to get their hbA1c checked every 6 months. Monitoring weight and waist circumference can provide even more valuable info. When lifestyle changes fail, metformin may come to the rescue. According to the D-CLIP trial, adding metformin to lifestyle changes can reduce incident diabetes by nearly 50% among persons with baseline BMI of 27 or greater. Working with your health care provider can help you achieve success and ensure that what you’re doing is right for you and that you can stick to it.
Prediabetes is not a death sentence. It’s a wake-up call and an opportunity to reverse the condition before it’s too late. Chances are you’ll never go back to being totally healthy, but you can still get back to normal. If you’re diagnosed today, you have about two years to make changes before the damage becomes permanent. Losing a few pounds, reducing carb consumption, increasing protein intake, exercising regularly, getting to sleep at a decent hour, and being consistent (in general) are all things that can get your blood sugar back to normal. Not easy tasks by any means, but they have to be weighed against the alternative, which is a lifelong prescription of drugs to control blood sugar and a whole host of side effects and costs. It’s not even close. Choose life.
